Clinical and angiographic outcome of paclitaxel-eluting stent implantation for unprotected left main coronary artery bifurcation narrowing.

Aims: This study was designed to compare the clinical and angiographic outcomes of paclitaxel-eluting stent (PES) and bare metal stent (BMS) implantation for unprotected left main coronary artery (LMCA) bifurcation narrowing.

Methods And Results: From November 2003 to December 2004, the technique of kissing balloon followed by T provisional stenting was applied for distal left main coronary lesion in 49 consecutive patients with PES stents. Data from this group were compared to those from 57 patients treated with BMS during the previous year. The procedural success rate was 100% for both groups. There were no incidents of death, stent thrombosis, Q-wave myocardial infarction (MI), or emergent bypass surgery during hospitalization in either group. Despite less acute gain (2.18+/-0.53 mm vs. 2.45+/-0.47 mm p= 0.078) in the PES group, PES patients showed a lower late lumen loss and a lower 8-month angiographic restenosis rate (6.1% vs. 35.1% p<0.0001) versus the BMS group. At 10 months, the rate of freedom from death,MI, and target lesion revascularization was 95.9+/-2.8% in the PES group and 66.1+/-6.3% in the BMS group (p<0.0001).

Conclusion: Paclitaxel-eluting stent implantation for unprotected LMCA bifurcation narrowing appears safe with regard to acute and midterm complications and is more effective in preventing restenosis compared to BMS implantation.